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This study included nearly 120,000 US nurses who were aged 25-42 and who had not been diagnosed (neither clinically nor surgically) with endometriosis at the start of the study.
The investigators collected detailed information about their diets over 12 years and identified those who were and were not diagnosed with endometriosis. Based upon animal studies and the investigators' understanding of the influence that fatty acids have on prostaglandin production and inflammatory responses, it was hypothesised that healthy fats known as Omega-3 fatty acids (the fats in fatty fish such as salmon and mackerel and in olive oil) would be more prevalent in the diets of women who remained free of endometriosis.
Conversely, it was hypothesised that the women with diets highest in the most unhealthy form of fat -- trans fats (which are hydrogenated oils found in many fried and processed foods) -- would have a greater risk of being diagnosed with endometriosis. This is indeed what was observed.
The authors stress that this is the first large, prospective study of the relation between fat in the diet and that these associations need to be replicated in additional populations.
"Hopefully this is evidence that large scale study of risk factors for endometriosis is possible and critical to understanding this enigmatic disease. Epidemiologic studies have been instrumental in identifying lifestyle factors that are now well substantiated recommendations from doctors to patients to prevent cardiovascular disease and several types of cancer. It is reasonable to believe that such modifiable factors are waiting to be identified for reproductive health as well", says Missmer, who added that "a next step could be to investigate whether dietary intervention that reduces trans fats and increases Omega-3 oils can alleviate symptoms in women who already have endometriosis".
The study has been funded by the US National Institutes of Health.
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